The Centers for Medicare & Medicaid Services (CMS) has implemented more rigorous standards for the Five-Star Quality Rating System for nursing homes. The standards now require additional data from hospital readmissions, a lower threshold for staffing penalties, and separate evaluations for short-term and long-term stays. The star-rating overhaul aims to improve the quality of care at nursing facilities around the country, in addition to improving the reliability of ratings, and comes as a response to criticism of CMS for being too lenient in the past.
Judge Dan Schneider was only 68 years old when he passed away from not receiving needed antibiotics in 2013 after 24 days at the Louisville nursing home campus of the Masonic Homes of Kentucky. Recently, the nursing home company and pharmacy have agreed to a settlement of nearly $13 million to the family.
In 2017, Kentucky enacted a law that required any medical malpractice claim to be reviewed by a panel of experts and an attorney before the claimants could file their suit in court. This caused a mandatory delay, contradicting Kentucky's own constitution that states every person has access to the courts without delay. At the end of 2018, this law was declared unconstitutional. Cases in Kentucky can move forward much faster now.
Fines against nursing homes that were found to injure or endanger their residents were significantly reduced after the Trump administration changed its policy on the issue. Average fines dropped from $41,260 in 2016 under the Obama administration to $28,405 under Trump. The reason why fines decreased so much is due to a policy that changed the way nursing homes in North Carolina and other states were fined. It changed from the number of days they were out of compliance to a single fine for each reported violation.
Virtually all skilled nursing facilities accept taxpayer dollars via Medicare. As a condition of being able to get paid Medicare dollars, Medicare has regulations that set minimum standards for the quality of nursing care provided in nursing homes. The purpose of these regulations is in part to ensure proper care is given in order to avoid neglect, injury, and even death to nursing home patients. These regulations, 42 CFR 483.25, address some of the more common types of problems we see in nursing home cases, problems that can lead to injury, or even death.